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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
S
M
I
J
U
R
S
U
R
Z
P
G
U
D
I
A
G
N
O
S
I
S
J
C
B
R
B
P
B
Q
D
H
L
E
S
Z
S
E
O
Z
W
E
V
J
L
R
E
W
C
D
M
Z
C
H
T
N
M
A
G
R
R
I
B
Z
G
E
N
P
E
C
R
N
I
V
V
H
C
G
W
F
T
I
A
J
B
O
G
A
A
G
M
D
A
D
H
V
E
R
L
L
D
E
R
U
D
E
C
O
R
P
S
O
H
A
C
L
L
M
E
Z
D
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